23D-101 (7) File M MP-2019-0065
APPLICANT/CONTACT PERSON SCIACCA]ONNA
ADDRESS/PHONE 219 NORTH MAIN ST (413)586-7706 O
PROPERTY LOCATION 136 HINCKLEY ST
MAP23DPARCEL101 OOI ZONE URBtI00V
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
FyN66QSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildina Permit Filled out
Fee Paid
Typcof Construction, ZPA-BUILD 2ND DWELLING ON BACK OF PROPERTY
New Construction
on Structural interior renovations
Addition to Existing
AccessoryStructure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING AC MN HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION F NTED:
_Approved —Additional permits required(see below)
PLANNING BOARD PERM REQUIRED UNDER: § TNBLE: 0 F USE
Interdia-Projem:Site
mePlan AND/ORSpecial Permit with Site Plan
Major Project: Site Plan AND/OR_____Special Permit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER:§
Finding Special Permit Variance'
Received&Recorded at Registry of Deeds Proof Enclosed
_Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
_Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
_Permit from Elm Street Commission Permit DPW Smmt Water Management
L / s` 323 I I
Signature of Building Official Date
Note: Wuance of Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
Variances aro granted only to those applicants who meet the strict standards of MGL 40A.Contact the Office of
Planning&Development for more information.
File No. M r9",q-C6 y -
ZONING PERMITAPPLIC477C N
Please type or print all information and return thih foruto h e B g
Inspector's Office with the$30filingfee (check or mo le o t e
City of Northampton
DEPT OE SUILDING INSPECTIONS
1. Name of Applicant• n NOPTHPMPI ON.MA 01060
Address: Telephone: YL3 S(�a 77 0�a
2. Owner of Property: f—
Address: /� �ZQ St Telephone:y/3 7Z(a__
3. Status of Applicant: Owner I/ Co�ntrtaR Purchaser_Lessee Other(e>plain)
4. Job Location: � CfIVYIIIIb /C.
Parcel Id: ZoMrit MapO a 3� Parcel# /0 / District(s):
In Ebn Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: S ! V J we Iti
6. Description of Proposed Use/WorWProject/Occupation: (Use additional sheets if necessary):
would /i/(e A build a second x.... 11 a on e- ba
Cir-pa f) F 4-heLopeKitl , tae 5k nz Aoax r'-),v2 -ry//
IO �t a_rS - C000/ /,' e A6
C0 - Tae Q/I rl we IFtJJ iii n rntd DVSe
7. Attached Plans: ch PWn Site Plan Engineered/Surveyed Plans
a. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW V YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW ,V/ YES
IF YES: enter Book Page and/or Document p
9.Does the site contain a brook, body of water or wetlands? NO V/ DONT KNOW YES
IF YES, has a pemdt been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , date issued:
ffm Continues On Other Side)
W:Vbcum UTORMSbngmenauilding-Irepaaa ing-Permit-Applicatiafpssiw.dw S4nM
;r..:
J
10. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
Are there any proposed changes to or additions of sign intended for the property? YES-NOL--
IF
OIF YES, describe size, type and location:
11. Will the construction activity disturb (clearing, grading, excavation, or filling)over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
12. ALL INFORMATION MUST BE COMPLETED,or PERMfT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
for use by the Building
Department
E339MG PROPOSED REQUIRED BY
,pp ZONING
Lot Size
V�)O &e res Z1
Frontage 0 f 0 /
Setbacks Front
,,,/ t71dr 50?
Yk" 5 side L: I(D' R- 32 ' L: 3D' R: a p/ L: R:
Rsair q110 /off
Bu114nr4g Height '.
Building Square Footage O fox,
/c � I PP one
%Open Space: (lot area u
minus building B 3/7 paved AC f e Q y'` A L re
parking7
&of Parking Spaces
#of Loading Docks
Fill:
(volume B location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date:'�'7"1�~Applicant's Signature —`
NOTE:Issuance of a zoning permit does not reli an applicant's burden to comply with aE zoning
requirements and obtain all required permits from the Board of Health,Conservation Commission,
Historic and Architectural Boards,Department of Public Works and other applicable permit granting
authorities.
W 8/4/1004
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